View clinical trials related to Emergency Service, Hospital.
Filter by:The goal of this campaign is to reduce unnecessary ED visits/encourage patients with low acuity visits to follow up with an appropriate provider and/or to seek care outside of the ED in the future. In this campaign, patients will be assigned to receive or not receive outreach following ED discharge that is aligned with the goal. Outreach will occur via a text message, as well as information added to the patient's after visit summary, and will include one or more calls to action that make patients aware of other Geisinger resources and avenues through which they can seek care outside of the ED. These may include, but are not limited to, walk-in urgent care, virtual urgent care, PCP appointments, and/or other ways in which to contact Geisinger. We will measure whether ED use differs across patients in different outreach conditions. We will also examine whether patients followed through on the message-specific calls to action in the messages differently across conditions.
Background: To evaluate the impact of COVID-19 on evaluations in the pediatric emergency department (ED) because of headache as main symptom. Methods: Number and clinical features of patients evaluated in the pediatric ED of a single site in Milan,Italy, were collected between January 2017 and January 2022. The impact of COVID-19 on evaluation rates was quantified by using the incidence rate ratio (IRR) and 95% confidence intervals (CI) between the pandemic (March 2020 to January 2022) and the prepandemic period (January 2017 to February 2020).
The goal of this clinical trial is to study whether the use of our blood culture prediction tool is non-inferior to current practice and if it can improve certain outcomes in all adult patients presenting to the emergency department with a clinical indication for a blood culture analysis (according to the treating physician). The primary endpoint is 30-day mortality. Key secondary outcomes are: - hospital admission rates - in-hospital mortality - hospital length-of-stay. In the intervention group, the physician will follow the advice of our blood culture prediction tool. In the comparison group all patients will undergo a blood culture analysis.
Introduction: Early and rapid diagnosis of etiology is often an important part of saving the lives of patients in emergency department. Chest CT is an important examination method for emergency diagnosis because of its fast examination speed and accurate localization. Traditional medical imaging diagnosis relies on radiologists to report in a qualitative and subjective manner. Through the interdisciplinary combination of clinical, imaging and artificial intelligence, the integration of multi-omics data, the construction of large-scale language models, and the construction of the auxiliary diagnosis support system of "one check for multiple diseases" provide new ideas and means for the rapid and accurate screening of emergency critical diseases. Method： Study design Investigators retrospectively collected cardiovascular, respiratory, digestive, and neurological CT images, demographic data, medical history and laboratory date of emergency department patients during the period from 1 January 2018 and 30 December 2024. Regularly carry out standardized follow-up work, and complete the collection and database establishment of clinical-imaging multi-omics data of patients attending emergency department.The inclusion criteria are:1. adult emergency patients with cardiovascular, respiratory, digestive, and nervous system diseases; 2. These patients had CT images. Patients with incomplete clinical or radiographic data were excluded from the analysis. Regularly carry out standardized follow-up work, and complete the collection and database establishment of clinical-imaging multi-omics data of patients attending emergency department. Based on the collected medical text data, an artificial intelligence large-scale language model algorithm framework is built. After the structure annotation of chest CT images is performed by doctors above the intermediate level of imaging, the Transformer deep neural network is trained for CT image segmentation, and a series of tasks such as structural structure segmentation, damage detection, disease classification and automatic report generation are developed based on Vision Transformer self-attention architecture mechanism. A multi-disease diagnosis and treatment decision-making system based on chest CT images, clinical text and examination multimodal data was constructed and validated. Disscusion Emergency medicine deals mainly with unpredictable critical and sudden illnesses. Patients who come to the emergency department for medical treatment often have acute onset, hidden condition, rapid progress, many complications, high mortality and disability rate. Assisted diagnosis systems developed by combining clinical text, images and artificial intelligence can greatly improve the ability of emergency department doctors to accurately diagnose diseases. This study fills the blank of CT artificial intelligence aided diagnosis system for emergency patients, and provides a rapid diagnosis scheme for multi-system and multi-disease. Finally, the results will be transformed into clinical application software and used and promoted in clinical work to improve the diagnosis and treatment level.
Malnutrition and inappropriate prescribing of renally excreted drugs are common among older persons and are associated with severe consequences such as complicated courses of treatment, mortality, and reduced quality of life. The overall purpose of CanPan is to optimize treatment of older persons with malnutrition with a focus on appetite stimulation and optimized prescribing of renal risk drugs. The CanPan trial consists of two sub-studies. Substudy 1 will provide knowledge on appetite and appetite stimulation and together, sub study 1 and 2 will offer unique knowledge on how body composition, renal function and biomarkers of organ function influence pharmacokinetics for a highly lipophilic (Sativex®) and hydrophilic (Hexamycin®) drug in older medical patients with malnutrition.
With lockdown, Emergency Departments (ED) visits decrease, principally for visits unrelated with Covid-19. In this study, the investigators aimed to find a correlation between ED visits and incidence rate of Covid-19 in a French metropolis.
Several studies have shown that going to the emergency room is a risk factor for loss of independence in the elderly. It has been shown that the period following an emergency room visit without hospitalization is a period of vulnerability for the elderly. The functional decline, or loss of functional autonomy, of the elderly is associated with an increase in institutionalization, mortality and costs to society. Studies have highlighted the risk factors for functional decline in the elderly, such as pre-existing functional and cognitive decline, undernutrition, but no model of care has yet prevented the risk of loss of autonomy after a stay in the emergency room. A full and early geriatric assessment could prevent functional decline after the emergency room visit. The primary objective of the study is to assess the impact of a dedicated geriatric sector on the functional decline at 1 month of patients admitted to emergencies without hospitalization by comparing an intervention group (patient having benefited from the geriatric sector) and a group witness ("classic" emergency patient). The secondary objective is to evaluate the impact of this sector on the number of falls at home as well as the readmission rate within 1 month of going to the emergency room.
Randomized controlled trial to determine the best brief suicide prevention intervention for adults and adolescents who screen positive for suicidal ideation or behavior in emergency departments or primary care clinics. Aim 1: Compare the effectiveness of two brief suicide prevention interventions (safety planning intervention plus structured phone-based follow-up from a suicide prevention hotline (SPI+), versus safety planning intervention plus caring contacts (CC)) to (a) reduce suicidal ideation and behavior, (b) reduce loneliness, (c) reduce return to care for suicidality, and (d) increase uptake of outpatient mental healthcare services over 12 months among adult and adolescent patients screening positive for suicide in emergency departments (EDs) and primary care clinics. Aim 2: Assess the acceptability of connection and support planning and the safety planning intervention, with or without follow-up among providers and clinical staff in EDs and primary care clinics. Aim 3: Assess the acceptability of SPI+ and SP+CC among adult and adolescent patients.
Since 2000, various emerging infectious diseases have repeatedly caused serious impact on the health of the global population and the healthcare systems. With the growing international transportation and improving accessibility of the healthcare systems, hospitals have been inevitably the first sentinels dealing with emerging infectious diseases. The biological disasters, such as the Severe Acute Respiratory Syndrome (SARS) in 2003, the Middle East Respiratory Syndrome (MERS) outbreak in South Korean in 2015, and the Coronavirus disease 2019 (COVID-19) outbreak this year, challenged our vulnerable healthcare systems and caused great loss of lives. Regarding the ongoing global epidemics and possible community outbreaks of the COVID-19, the management of biological disasters for an overcrowded emergency department should be planned. In the early 2020, the emergency department used a double-triage and telemedicine method to treat non-critical patient with suspected COVID-19. This application reduced the exposure time of the first responders and reserve adequate interview quality. However, for the critical patients treated in the isolated resuscitation rooms, the unique environment limited the teamwork and communication for the resuscitation team. These factors might led to poorer quality of critical care. The investigators designed a telemedicine-teamwork model, which connected the isolation room, prepare room and nursing station by an video-conferencing system in the emergency department. This model try to break the barriers of space between the rooms and facilitate the teamwork communications between each unit. Besides, by providing a more efficient workflow, this model could lower the total exposure time for all workers in the contaminated area. This study was conducted to evaluate the benefits of the telemedicine-teamwork model and provide a practical, safe and effective alternative to critical care of the patients with suspected highly infectious diseases.
Since December 2019, when the novel coronavirus disease (Covid-19) spread throughout the world, data have been needed on the effects of the pandemic on various aspects of healthcare systems. Recommendations for social distancing and quarantine decrees made by local governments, alongside the general public fear from the spread of the virus, are presumed to have markedly affected the trends in hospitals visits. Understanding the exact nature of the effect is critical for better anticipating and preparing health systems in the event of future outbreaks and in the post outbreak period. Therefore we intend to To identify retrospectively all patients who presented to the emergency department at our medical institute between January 1 - March 31 in the following years: 2017, 2018, 2019, 2020. We will examine the impact of COVID-19 on the rates of surgical emergency visits, ratio of surgical visits to non-surgical visits, the ratio of severe presentations to non-severe presentations, and the impact of age on ED attendance.